Would you recycle 3TC into a regimen containing AZT (or D4T), DDI (or DDC) and Sustiva in the presence of low level viremia (e.g. >50 but <500)? Might this be helpful in reducing VL since the M184V mutation reverses resistance to some other mutations, or might this be harmful since still more mutations could emerge that limit the future efficacy of combos with Tenofovir or newer NRTIs or NNRTIs under development?

Response from Dr. Little

I would not likely use 3TC in this setting if it was thought that drug resitance to 3TC had developed previously. I might introduce 3TC with Tenofovir in this setting, but this would depend on what other options/limitations were present in choosing a treatment regimen. Part of the reason to pick combinations that are more of a "sure thing" is to protect the other drugs in the regimen. So I try hard not to come close to an effective regimen, but rather aim for one that I have a greater degree of certainty with.

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

The Body is a service of Remedy Health Media, LLC, 750 3rd Avenue, 6th Floor, New York, NY 10017. The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.